Development and validation of prediction model to estimate vertigo risk after endolymphatic sac decompression in Meniere's disease: a retrospective cohort study.

PURPOSE: To study the efficacy predictors of endolymphatic sac decompression (ESD) in Meniere's disease (MD), and to establish and verify the prediction model of vertigo after ESD in patients with MD. METHODS: The retrospective cohort data of 56 patients with unilateral MD who underwent ESD surgery were recorded. A stepwise regression method was used to select optimal modeling variables, and we established a logistic regression model with the outcome of vertigo after ESD. The bootstrap method was used for internal validation. RESULTS: Potential predictors included sex, age, follow-up duration, disease course, attack duration, frequency of attack, pure-tone threshold average (PTA) of the patient's speech frequency, audiogram type, glycerin test results, MD subtype, and 10-year atherosclerotic cardiovascular disease risk classification. Using the stepwise regression method, we found that the optimal modeling variables were the audiogram type and PTA of the patient's speech frequency. The prediction model based on these two variables exhibited good discrimination [area under the receiver operating characteristic curve: 0.72 (95% confidence interval: 0.57-0.86)] and acceptable calibration (Brier score 0.21). CONCLUSION: The present model based on the audiogram type and PTA of the patient's speech frequency was found to be useful in guidance of ESD efficacy prediction and surgery selection.

Force Balance Reconstruction of the Orbicularis Oris in Secondary Unilateral Cleft Lip Deformity.

BACKGROUND: Secondary unilateral cleft lip deformities are commonly observed in patients with cleft lip and traditional surgical methods can't completely tackle this problem. The purpose of this study was to evaluate the outcomes of a novel surgical technique using force balance reconstruction of the orbicularis oris. METHODS: 53 patients with secondary unilateral cleft lip deformity were included in this study, in which the orbicularis oris muscle was reconstructed symmetrically to achieve optimal force balance. Photometric 2d indexes were employed to evaluate the outcome of 27 patients, and 3d indexes for the remaining 26 patients. Aesthetic evaluation and parent-patient satisfaction surveys were also recorded. RESULTS: Significant differences were found in the following: (1) LH (the lip height), LW (the lip width), D1(the vertical distance from the white roll to the vermilion bottom at the christa philtra points) and D2(the vertical distance from the christa philtra points to the facial midline) when comparing preoperative and postoperative 2D images; (2) LH, LW, D1 and D2 when comparing preoperative and follow-up 2D images; (3) RMS (root mean of square) when comparing preoperative and postoperative 3D images. Aesthetic evaluation in the follow-up period was a mean of 4.29, while parent-patient satisfaction of the overall appearance was a mean of 4.41. CONCLUSIONS: The results suggest this new muscle reconstruction technique can significantly improve the surgical outcome of secondary unilateral cleft lip deformities. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ."

Reciprocal Relationship Between Learning Interest and Learning Persistence: Roles of Strategies for Self-Regulated Learning Behaviors and Academic Performance.

Learning interest (internal driving motivation) and learning persistence (explicit behaviors) are important factors affecting students' academic development, yet whether they operate reciprocally and how to bolster them are still issues requiring attention. This study aimed to examine the reciprocal relationship between learning interest and persistence as well as the potential mechanisms behind the relationship from the perspectives of internal self-regulation and external feedback (i.e., academic performance). 510 students (Mage = 13.71, SD = 1.77, 44.1% girls) were tracked for one year using questionnaires. Results showed that higher learning interest was linked to greater subsequent learning persistence and vice versa; and both predicted each other over time indirectly through academic performance and the multiple mediating paths from strategies for self-regulated learning behaviors to academic performance. Ancillary analysis verifies the robustness of these results. The findings not only provide evidence of a dynamic relationship between learning motivation and behaviors, highlighting the important role of positive performance feedback in leading to a benign cycle, but also contribute to understanding the potential avenue (i.e., teaching strategies for self-regulation) for optimizing student learning.

Labial-Nasal Evaluation for Nasal Floor Reconstruction With the New Triangular Flap in Unilateral Cleft Lip Repair.

In this study, we present a modified technique for primary cleft lip repair with a rotation triangular flap from the cleft lateral side to reconstruct the nasal floor; and evaluate the outcome compared with traditional Millard repair.40 patients with unilateral cleft lip were included in this research. The patients were divided into 2 groups; 17 patients treated with the Millard technique, and 23 patients treated with the newly modified technique. 14 measurement indexes were employed to evaluate the nose-lip morphology of postoperative patients with UCCL in standardized photographs preoperatively, postoperatively and 1-year follow-up.For lip symmetry, statistical significance was detected in the measurements of the vertical philtral height ratio indicating that the newly modified technique resolve the shortage of lip height on the cleft side 1-year follow-up. (P < .05). In addition, statistical significance was detected in the 1-year postoperative columellar angle, alar width ratio, nostril width ratio, nostril height ratio, and nostril shape (cleft) (P < .05), showing more successful repair of the nose compared with the traditional repair.The modified unilateral cleft lip repair with rotation triangle flap from the cleft lateral side was beneficial in the correction of lip and nasal deformity in and had positive effects on labial symmetry.

Perceived Social Mobility and Smartphone Dependence in University Students: The Roles of Hope and Family Socioeconomic Status.

Purpose: Drawing upon the cognitive-behavioral model of pathological Internet use (PIU) and tunnel effect, this study aimed to construct a moderated mediation model from the perspective of social ecology. Specifically, the model investigated the relationship between perceived social mobility and smartphone dependence, with a focus on the mediating role of hope and the moderating effect of family socioeconomic status (SES) underlying this relationship. Methods: A cross-sectional study was conducted with 718 Chinese university students (Mage = 19.19, 70.2% female) from Beijing, Henan, and Tianjin, who anonymously filled out the Perceptions of Socioeconomic Mobility Scale, Mobile Phone Addiction Index Scale, Openness to the Future Scale, and family socioeconomic status questionnaire. Preliminary data analysis was executed using SPSS 22.0, and the moderated mediation effect was tested using the latent moderated structural equations approach in Mplus 8.3. Results: The results showed that (a) less perceived social mobility was linked with greater smartphone dependence; (b) hope mediated the aforementioned relationship; and (c) family SES moderated the first-stage path of the indirect effect through hope. For university students with low (rather than high) family SES, their level of hope increased with the improvement of perceived social mobility, and in turn, that of smartphone dependence decreased. Conclusion: These findings suggest that positive perceptions of upward social class mobility and hopeful attitudes toward future opportunities and personal development among disadvantaged university students may alleviate their reliance on smartphones. Researchers and policymakers should pay attention to the role of individuals' perceptions of the macro environment in motivating specific risky behaviors among university students. Future interventions are essential to mitigate pessimistic environmental perceptions and foster a sense of hope among university students.

5-year Long-term Outcome of Unilateral Cleft Rhinoplasty in Patients with Secondary Nasal Deformity: Optimal Indication of Tajima Technique.

BACKGROUND: This study aimed to investigate the timing of and indications for the Tajima reverse U incision for correcting secondary unilateral cleft nasal deformities. METHODS: Non-syndromic patients with secondary cleft lip and nasal deformity who received Tajima reverse-U incision rhinoplasty were grouped by age (4-13 years, n=56;13-18 years, n=22; >18 years, n=18) and severity of deformity (mild deformity, n=7; moderate deformity=22; severity deformity=67) during 5-year follow-up. Face-Q assessment, a rating scale, and nasal symmetry measurements were employed in this study. RESULTS: Ninety-six patients completed the FACE-Q assessment for the nose and nostril. The results showed higher satisfaction with nostril appearance 1-week after surgery (85.95±13.01) compared with pre-operation (79.72±11.89) and maintained 5-year follow-up (82.61±14.06). Significant differences were observed in five nasal parameters (nasal height ratio, one-fourth media part of nostril height ratio, nasal sill height ratio, columellar angle, and inner nostril height-to-width ratio (cleft)) for 1-week postoperatively and the corrected outcome of the Tajima technique was maintained 5 years after surgery in aged 4-13 years group. The same statistically significant changes were found in nasal sill height ratio in mild deformity group and nostril width ratio, one-fourth media part of nostril height ratio, columellar angle, and inner nostril height-to-width ratio (cleft) in moderate deformity group. CONCLUSION: The Tajima procedure was beneficial for preadolescent children and children with mild to moderate unilateral cleft nasal deformities.

Novel Reconstruction of Orbicularis Oris in Unilateral Complete Cleft Lip Repair.

Background: Orbicularis oris muscle repair is key to successful unilateral cleft lip repair. Objective: To measure the lip symmetry after repair of the lip muscles in the midline compared with traditional repair on the cleft side. Methods: A retrospective review and photographic analysis of patients with complete cleft lip treated with the modified approach were carried out. Anthropometric analysis was done at pre-, immediate, and 1-year postoperatively, and at 1-year follow-up. Four upper lip and six nostril landmarks were measured. Results: Fourteen patients met inclusion criteria. Immediate postoperatively, the horizontal lip length on the cleft side was shorter than that on the noncleft side, but the discrepancy decreased as facial development progressed over the course of a year. Lip measurements at the 1-year follow-up were approximately symmetrical in vertical lip height, philtral height, and lateral lip height. Small changes in the nasal correction occurred at 1 year. Conclusion: A modified technique in the unilateral complete cleft lip repair seeks to balance the perinasal and perioral muscles and improve symmetric outcomes.

Intraoral Scanning Evaluation Of Maxillary Arch Changes Post Modified Sommerlad Palatoplasty For Around Three Years.

BACKGROUND: To investigate the postoperative effect of dental arch changes in cleft palate patients with modified Sommerlad palatoplasty by intraoral scanning technique in early deciduous dentition children. METHODS: Patients (n=60) with non-syndromic unilateral complete cleft lip with palate (UCLP) or cleft palate only (CPO) treated by modified Sommerlad palatoplasty without relaxed excision before 18 months old and 95 healthy controls without cleft were included. Three-dimension images of the maxillary dental arches of all subjects aged 3 to 4 years were obtained by intraoral scanning (IOS) technique. Seven parameters including anterior dental arch width (Ar-Al), middle dental arch width (Fr-Fl), posterior dental arch width (Sr-Sl), anterior palatal arch width (Cr-Cl), posterior palatal arch width (Mr-Ml), anterior dental arch length (IP-D) and entire dental arch length (IP-O) were measured. RESULTS: Compared with male group, the Mr-Ml distance of controls in female group statistically decreased (p=0.039) and the Fr-Fl, Sr-Sl, Mr-Ml distance of female patients decreased (p=0.013, p=0.002, p=0.005). The IP-D, IP-O distance of children in UCLP group was shorter than those of CPO children (p＜0.0001, p＜0.0001). Patient group showed decreased distance of Ar-Al, Cr-Cl, IP-D and IP-O and increased distance of Sr-Sl and Mr-Ml compared with control group (p=0.0002, p=0.002, p<0.0001, p<0.0001, p=0.007, p=0.027). CONCLUSION: The results indicated that the modified palatoplasty showed no growth inhibition in the middle, posterior dental arch width, and palatal arch width, though slightly but significantly inhibition in the length of anterior and entire dental arch. CLINICAL QUESTION/ LEVEL OF EVIDNCE: Risk, III.

Outcome Comparisons of Two Different Orbicularis Oris Muscle Reconstruction Techniques in Patients with Unilateral Incomplete Cleft Lip.

OBJECTIVE: The long-term postoperative outcomes of two different orbicularis oris muscle reconstruction techniques in patients with unilateral incomplete cleft lip were compared. METHODS: Forty-seven patients with unilateral incomplete cleft lip were assessed in this study, where 23 underwent a traditional method of reconstruction and 24 underwent a novel method. Preoperative measurements, postoperative results, and three-year follow-up outcomes were measured by photographic anthropometric analysis. Five upper-lip measurement indices and eight nostril indices were included. RESULTS: The postoperative outcomes showed that the shape of the lip and nose was more symmetrical with the new surgical method compared with the conventional technique. Long-term outcomes after three years, although characterized by minimal changes during maxillofacial development, showed better maintenance of lip and nostril symmetry in the novel-method group. CONCLUSION: The novel technique seeks to balance the perinasal and perioral muscles, resulting in improved symmetry compared with the traditional reconstruction technique.

Aesthetic evaluation of nasolabial reconstruction using abbe flap in bilateral cleft lip patients with secondary deformities.

BACKGROUND: The Abbe flap is a common technique frequently utilized in secondary surgery for bilateral cleft lip deformities, but objective indications for the Abbe flap remain unclear, and postoperative aesthetic evaluations are limited. METHODS: The study group consisted of 92 bilateral cleft lip patients with secondary deformities aged 7-39 years, and the control group consisted of 33 people aged 19-35 years. Thirteen objective nasolabial aesthetic parameters were selected to evaluate patients' nasolabial aesthetics. RESULTS: Minor secondary deformities were characterized by a smaller lip height index than severe deformities, as well as a smaller columellar angle compared with moderate and severe deformities (P < 0.05). For all patients, significant differences were found between preoperative and postoperative values of intercanthal distance/medial upper vermilion height ratio, intercanthal distance/medial upper lip height ratio, lip height index, lip vermilion height index, lip protrusion angle, columellar-labial angle, and nasal tip angle (P < 0.05). For patients with minor deformity, intercanthal distance/philtrum width ratio and intercanthal distance/medial cutaneous upper lip height ratio showed no significant change postoperatively (P > 0.05), and labial protrusion angle was smaller than the control group (P < 0.05). CONCLUSIONS: Patients undergoing secondary surgery using an Abbe flap achieved good nasolabial aesthetics. Intercanthal distance/medial upper vermilion height ratio, intercanthal distance/medial upper lip height ratio, lip height index, columellar-labial angle, nasolabial angle, nasal tip angle, and columellar angle are the objective aesthetic indicators for Abbe flap selection. Intercanthal distance/philtrum width ratio, intercanthal distance/medial cutaneous upper lip height ratio, and labial protrusion angle are reference parameters for choosing an Abbe flap for secondary bilateral cleft lip revision.

The Effect of Functional Motivation on Future Intention to Donate Blood: Moderating Role of the Blood Donor's Stage.

The low retention rate and lack of long-term blood donors are still worldwide problems, and the fostering and retaining of more blood donors has posed an urgent problem that requires a solution. The purpose of this study was to explore the role of functional motivation and blood donor stage in the future intention to donate blood. Three sites in China provided 252 blood donors who filled out a questionnaire including the volunteer function inventory, their future intention to donate blood, number of blood donations and demographic information. Based on a functional motivation approach, we investigated the motivations that influence unpaid blood donors' future intention through qualitative interview methods. The results showed that blood donor stage moderated the relationship between values motivation and future intention to donate blood. More specifically, the predictive effect of values motivation on future intention decreased gradually from new donors to regular donors. Our study found that the effect of various motivations on blood donors' intention was conditional; this effect changed with the development of blood donor behavioral stages. The results are significant in practice for establishing effective intervene strategies in maintaining blood donors.

Does Basic Psychological Need Satisfaction Matter to College Students' Sustained Volunteering? A Mixed-Methods Study.

Based on the self-determination theory (SDT), this study used a mixed-methods (i.e., quantitative and qualitative approaches) design to explore the role of basic psychological need satisfaction (BPNS) played in sustained volunteering. Quantitative analysis of 803 college student volunteers revealed that competence and relatedness need satisfaction had significant associations with sustained volunteering, while autonomy need satisfaction did not. Furthermore, latent profile analyses identified five profiles of BPNS: low (Profile 1), relatively low (Profile 2), moderate (Profile 3), low autonomy-high competence and relatedness (Profile 4), and high (Profile 5). Volunteers in Profile 4 and Profile 5 reported higher sustained volunteering than those in other profiles. Subsequent qualitative synthesis of interview data from 33 college student volunteers found that competence need satisfaction (45.58%) was mentioned most frequently among the factors promoting sustained volunteering, then followed by relatedness (27.43%) and autonomy need satisfaction (11.06%). These findings highlight the important role of BPNS, especially competence and relatedness need satisfaction, in promoting college students' long-term volunteering.

Service-Learning and Chinese College Students' Knowledge Transfer Development.

As a form of experiential education, service learning (SL) shows great potential for promoting students' knowledge transfer as it offers students opportunities to apply what they have learned in classrooms to serve communities in real-life contexts. To explore how students' knowledge transfer evolves during SL, we collected longitudinal survey data from 96 Chinese college students in a 9-week SL program. Results indicate that (a) students' perceived knowledge transfer in SL did not follow a linear trajectory. Although students' perceived knowledge transfer at the end of SL was significantly higher than those at the beginning, a slight drop was observed in the middle of SL; (b) the developmental pattern of perceived knowledge transfer varied across students; and (c) students' perceived knowledge transfer development during SL was associated with mastery goal orientation and perceptions of psychologically controlling behaviors from their SL supervisors. By providing evidence of the dynamic process and mechanisms of students' knowledge transfer development, the present study adds to our understanding of how, when, and why the benefits of SL are realized.

Not Only Top-Down: The Dual-Processing of Gender-Emotion Stereotypes.

Is gender-emotion stereotype a "one-hundred percent" top-down processing phenomenon, or are there additional contributions to cognitive processing from background clues when they are related to stereotypes? In the present study, we measured the gender-emotion stereotypes of 57 undergraduates with a face recall task and found that, regardless of whether the emotional expressions of distractors were congruent or incongruent with targets, people tended to misperceive the fearful faces of men as angry and the angry faces of women as fearful. In particular, there was a significantly larger effect in the distractor-incongruent condition. The revised process-dissociation procedure analysis confirmed that both automatic and controlled processing have their own independent effects on gender-emotion stereotypes. This finding supports a dual-processing perspective on stereotypes and contributes to future research in both theory and methodology.

Regulatory Focus and Subjective Well-Being: The Mediating Role of Coping Styles and the Moderating Role of Gender.

Although previous research has suggested that regulatory focus may exert considerable impacts on individuals' subjective well-being (SWB), little research has explored the mechanism for this relation and the potential gender difference. The current study investigated the potential mediating effects of coping styles on the relationship between regulatory focus and three aspects of SWB (indicated by life satisfaction, positive affect, and negative affect) among Chinese adolescents. Total of 2943 Chinese adolescents participated in this cross-sectional survey and completed self-reported questionnaires (Mage = 14.47, SD = 1.59, 44.50% boys). Hypothesized pathways were tested by structural equation models. Results showed that regulatory foci were significantly associated with SWB. Promotion focus predicted SWB mainly through problem-focused coping, and the mediating effects of emotion-focused coping were also observed; Prevention focus predicted SWB mainly through emotion-focused coping, and the mediating effects of problem-focused coping were observed. Furthermore, relative to boys, the prediction of problem-focused coping on life satisfaction was stronger and the prediction of promotion focus on life satisfaction was weaker for girls. These findings provide a new approach to understand the mechanism for the relationship between regulatory foci and SWB, and indicate the gender differences of this process.

The Dampening Effects of Perceived Teacher Enthusiasm on Class-Related Boredom: The Mediating Role of Perceived Autonomy Support and Task Value.

Class-related boredom is commonly experienced by students and it has an impact on their learning engagement and achievements. Previous research has found that perceived teacher enthusiasm might contribute to reducing students' class-related boredom. However, the mechanism through which perceived teacher enthusiasm affects class-related boredom remains unexplored. The purpose of the present study was to investigate the mediating role of perceived autonomy support and task value in the relationship between teacher enthusiasm and class-related boredom. College students (N = 734) completed questionnaires on perceived teacher enthusiasm, boredom proneness, perceived task difficulty, perceived autonomy support, perceived task value, and class-related boredom. Results showed that after controlling for the effects of demographic variables, boredom proneness, and perceived task difficulty, both perceived autonomy support and task value fully mediated the relationship between perceived teacher enthusiasm and class-related boredom. These findings suggest that students who perceive more teacher enthusiasm might perceive more autonomy support and task value, which in turn reduce the students' class-related boredom. Limitations in the present study have also been discussed.

Can nursing students' perceived teacher enthusiasm dampen their class-related boredom during theoretical lessons? A cross-sectional study among Chinese nursing students.

BACKGROUND: Class-related boredom experienced by nursing students during theoretical lessons may affect their health and learning outcomes. Perceived teacher enthusiasm of nursing students may dampen their boredom, but little empirical research has investigated their relationship. OBJECTIVES: The aim of the current study is to investigate the dampening effects of nursing students' perceived teacher enthusiasm on their class-related boredom during theoretical lessons. The main theoretical framework is control-value theory of achievement emotions. DESIGN: A cross-sectional survey was used. METHODS: 352 nursing students during their theoretical lessons completed questionnaires on perceived teacher enthusiasm, boredom proneness, perceived task difficulty and class-related boredom. Correlation and classic multiple hierarchical analysis results supported the hypothesis about the relationships among variables. RESULTS: After controlling the effects of demographic variables, boredom proneness and perceived task difficulty, perceived teacher enthusiasm negatively predicted class-related boredom significantly. CONCLUSION: Perceived teacher enthusiasm of nursing students can predict their class-related boredom significantly.

The Role of Subjective Task Value in Service-Learning Engagement among Chinese College Students.

Most service-learning studies in higher education focused on its effects on students' development. The dynamic processes and mechanisms of students' development during service-learning, however, have not been explored thoroughly. Student engagement in service-learning may affect service-learning outcomes and be affected by subjective task value at the same time. The present study aimed to explore the effect of subjective task value on Chinese college student engagement during service-learning. Fifty-four Chinese college students participated in a 9-weeks service-learning program of interacting with children with special needs. Students' engagement and subjective task value were assessed via self-report questionnaires and 433 weekly reflective journals. The results indicated that the cognitive, emotional and behavioral engagement of Chinese college students demonstrated different developmental trends during service-learning process. Subjective task value played an essential role in student engagement in service-learning activities. However, the role of subjective task value varied with different stages. Finally, the implications for implementing service-learning in Chinese education were discussed.

The effects of initial participation motivations on learning engagement in transition training for future general practitioners in rural China: perceived deterrents as mediator.

BACKGROUND: For the shortage of high-quality general practitioners (GPs) in China's rural areas, Chinese government has taken steps to encourage rural specialists to participate in transition training for future GPs. Specialists' initial participation motivations and their perceived deterrents during training may play important roles for their learning engagement in the transition training. This study aimed at revealing the relationships among the variables of initial participation motivations, perceived deterrents in training, and learning engagement. METHODS: A questionnaire survey was used in this study. A total of 156 rural specialists who participated in transition training for future GPs filled out the questionnaire, which consisted of the measurements of initial participation motivations, perceived deterrents, and learning engagement in training. The data about specialists' demographic variables were collected at the same time. RESULTS: The variance of initial escape/stimulations motivation significantly predicted the variance of learning engagement through the full mediating role of perceived deterrents in training. In addition, initial educational preparation motivations predicted the variance of learning engagement directly. CONCLUSIONS: Specialists' initial participation motivations and perceived deterrents in training played important roles for learning engagement in the transition training.